Understanding Hiccups: Types, Causes, and Symptoms Explained

Types of Hiccups

Hiccups are involuntary contractions of the diaphragm. Knowing the type can indicate whether they are harmless or a sign of an underlying issue.

• Acute Hiccups: Short-term hiccups lasting for a few minutes to hours, usually due to eating too fast, drinking fizzy drinks, or stress. Harmless and go away on their own.
• Persistent Hiccups: Hiccups that last more than 48 hours but less than a month, often caused by acidity (GERD), diaphragm irritation, or nerve problems. Need medical advice.
• Intractable Hiccups: Very rare, lasting over a month, linked to serious issues like brain injury, stroke, or diabetes. Requires proper medical treatment.
• Singultus from Specific Triggers: Caused by things like spicy food, alcohol, smoking, or laughing too much. Stop when you avoid the triggers.

Hiccups Common Causes

Hiccups are typically harmless but may occasionally indicate an underlying issue.The most prevalent triggers for hiccups lasting less than 48 hours are:

• Consuming carbonated beverages.
• Drinking too much liquor.
• Overeating.
• Mental stress and anxiety.
• Sudden temperature changes.
• Swallowing air (e.g., chewing gum or smoking).

Hiccups that last more than 48 hours may be due to:

Nerve Damage or Irritation

Long-term hiccups can be caused by injury or irritation to the vagus or phrenic nerves that feed the diaphragm muscle. Factors that may harm or irritate these nerves include:

• Something in your ear, such as a hair, is contacting your eardrum.
• A tumour, cyst, or growth on the thyroid gland in the neck.
• Stomach acid backs up into the oesophagus.
• Sore throat or laryngitis.

Central Nervous System Disorders

A tumour or infection in the central nervous system, as well as damage to the central nervous system from an accident, can disrupt the body's normal control of the hiccup reflex.

• Encephalitis.
• Meningitis.
• Multiple sclerosis.
• Stroke.
• Serious brain injury.
• Tumors.

Metabolic Issues

Long-term hiccups may result from your body's metabolism not working properly, such as in:

• Diabetes.
• Electrolyte imbalance.
• Kidney disease.

Certain Drugs and Alcohol Issues

Long-term hiccups may be caused by certain drugs or alcohol problems, such as:

• Sedatives or other drugs used for anesthesia.
• Dexamethasone, used to relieve inflammation in conditions such as arthritis, asthma, and kidney problems.
• Other steroids.
• Alcohol use disorder.

Conditions that Cause Hiccups

Persistent or chronic hiccups may be associated with underlying health problems.

• Gastroesophageal reflux disease (GERD)
• Central nervous system disorders (e.g., multiple sclerosis, stroke)
• Metabolic disorders (e.g., diabetes, kidney failure)
• Post-surgical irritation (especially involving abdominal/thoracic procedures)

Hiccups Related Symptoms

Hiccups are sometimes accompanied by other signs indicating a more serious condition. The symptoms of hiccups include:

• Repetitive "Hic" Sound: A characteristic involuntary sound caused by diaphragm contractions.
• Rhythmic Spasms: Sudden, repetitive jerks or contractions of the diaphragm.
• Mild Chest or Throat Discomfort: A sensation of tightness or irritation accompanying hiccups.
• Interrupted Speech: Difficulty speaking due to the involuntary nature of hiccups.
• Occasional Fatigue: Persistent hiccups may cause tiredness or discomfort.

Hiccups are generally harmless but can be bothersome if prolonged. Persistent hiccups lasting over 48 hours may indicate an underlying issue and require medical attention.

When to See a Doctor?

While usually harmless, hiccups can signal a more serious concern if persistent.

• Hiccups lasting more than 48 hours
• Difficulty breathing or swallowing
• Associated neurological signs (e.g., confusion, balance issues)
• Ongoing sleep disturbance
• Interference with eating or daily activities
• No clear cause despite lifestyle changes

Hiccups Diagnosis & Tests

Evaluation focuses on identifying possible underlying causes.

Physical Exams:

Neurological exam, abdominal assessment, throat inspection.

Lab Tests:

Electrolyte levels, renal function, blood glucose.

Imaging Tests:

Chest X-ray, MRI brainstem (if neurological issues suspected), upper GI endoscopy.

Specialized Diagnostics:

pH monitoring (for GERD), esophageal manometry.

Hiccups Treatment & Management

Treatment depends on duration and underlying cause of hiccups.

Medications:

Baclofen, chlorpromazine, metoclopramide (for persistent/intractable cases).

Therapies:

Breathing techniques, vagus nerve stimulation.

Prevention Tips:

Eat slowly, avoid carbonated drinks, reduce stress and avoid large meals.

Home Remedies:

Holding breath, sipping cold water, swallowing sugar, breathing into a paper bag.

Lifestyle Changes:

Avoid irritants like smoking/alcohol, manage GERD symptoms, and ensure proper hydration.

Hiccups are typically harmless but may indicate underlying conditions if persistent. Timely evaluation ensures appropriate treatment and relief.